Category Archives: basal rates

Fiasp Insulin. The New Kid on the Block

Fiasp Insulin the new kid on the blockIt has been a long  time since the diabetes world has seen a new rapid acting insulin brought to market.  The last one that I can remember was  Apidra released back in 2004.  It is  not surprising  then that the release of Fiasp by NovoNordisk is creating a lot of buzz.  Not to be let out, my son recently began using this insulin. Since Fiasp insulin is the new kid on the block, I thought I would give everyone a brief rundown on the highs and lows associated with it.

What is it?

Fiasp insulin was released by NovoNordisk onto the Canadian market in March of 2017.  Many of us scrambled to get a prescription because it promised better blood glucose levels without pre-bolusing for meals! According to the press release, you can dose up to two minutes before a meal and up to 20 minutes after starting a meal without compromising overall glycemic control or safety!*

How is it different?

A Medscape article states that  Fiasp is  absorbed twice as fast as its counterparts.

It does this with the help of  two excipients–Vitamin B3 is responsible for the increase in the speed of absorption and Amino Acid (L-Arginine)  has been added for extra stability.**

What do users think?

All of this science is great but most people are wondering how well it works in real life settings.  From what I have seen, the bulk of users really like it.  I could only find one person out of about a dozen users who had returned to their old insulin aspart.

When I asked my son for his review I was told “I still have highs. I still have lows BUT if I have a heavy carb  loaded meal, Fiasp kicks butt and I don’t have the same crazy swings that I always did before.” For a 19 year old who can definitely binge on carbs, this is huge.

Other users seem to have  had similar results.

Some people with diabetes found that the insulin peaks were no longer as pronounced.  They had some difficulty battling highs with Fiasp however while others found it perfect for corrections. In fact some people are purchasing Fiasp just for corrections.

Other users explained that the faster insulin action allowed them to more quickly respond to rising blood glucose levels.  This in turn meant resulted in much  tighter control.  The quick action has  also left one user to caution about the timing of any  prebolus.

Most seemed to agree that Fiasp insulin resulted in fewer food spikes and more stable blood glucose levels but as I said not everyone loves it.  For some users, their traditional rapid acting insulin seemed to work better.

Final thoughts…

All in all, most people with diabetes who are  trying the new kid on the block seem to be happy with it.  It offers another insulin choice  for those who struggled with post-meal spikes or don’t pre-bolus meals.

It must also be noted however that while Fiasp is not currently approved for use in insulin pumps in Canada, both those on insulin pumps and MDI are using this insulin aspart.

Finally, I was also happy to see that the price of Fiasp insulin was par with NovoRapid.  This meant that there was no need to worry about an increased cost for out of pocket insulin expenses.  My understanding is that Fiasp insulin is not yet on many (or any) provincial formularies.  This most likely will mean that if you decide to use the insulin and are currently using a publicly funded program, you may have to either pay for this insulin out of pocket or speak to your doctor about having special authorization added to your benefits to ensure full coverage.

Please remember to check with your diabetes team before starting any new insulin regimen. 

*http://www.novonordisk.ca/content/dam/Canada/AFFILIATE/www-novonordisk-ca/News/Fiasp_Launch_PR_English.pdf

**http://www.medscape.com/viewarticle/877892

 

The Mocking Meter

It was four in the morning. I had over slept. I had wanted to check my son by three.  I had increased his basal rate to deal with reoccurring highs but he had also been doing yard work that evening and I was not sure how things were going to go in the diabetes world. 

I stumbled into his room, made my way through the landmine of dirty socks, old t-shirts and the fan he has sitting on the floor. I found the meter, strips and even a lancing devise this time. He lost one the previous night. It has yet to be found but I am sure will surface one day when I least expect it!

I tested and found that he was high.  I cursed. I felt like there was no winning.  I then looked at the meter a little closer. In the top left hand part of the screen was a little text box. It was like the meter wanted to tell me something.  We are using a Verio IQ at the moment so I know that the meter did want to tell me something. 

It had noticed the pattern of highs that he has been having overnight. At four in the morning, when you are tired and frustrated because diabetes has once again messed you (and your child) up completely…(I mean he should have been low not high after an upped basal AND physical activity), the last thing you want to see is a know-it-all blood glucose meter telling you the obvious–Diabetes kicked your butt once again! 

Looking at that small little icon, I could hear the meter say “He is high. He has been high at night for some time.  You really should up his basal rate.  This can cause problems later. What is wrong with you? Why haven’t you done this already? Are you thick? I am giving you the icon.  Get with it won’t you!”

I cursed a little more and left the room. Maybe I will get it right tonight…maybe but probably not. 


The importance of time changes

As you know if you read my blog regularly,  we were recently on the west coast for a bit.  That means changing our bodies and our clocks back 4.5 hours.  Its a bit of a challenge for the first few days but my son’s teenage body can sleep until noon in any time zone!

The challenge for Mom was how to deal with his pump.  I have spoken to people before who do not bother to change their time on their pumps if they are not going to be away for very long. We were gone for about 10 days so I felt that a change was needed. I gave his body two days to adjust and then reset the time on  his pump. All seemed to work fine. 

When we came home I reminded my son to set his pump back to local time. He did as he was told and I thought nothing more of it…until we had a site issue.  

My son was high and he needed a site change.  As he dug out his supplies, I looked through his pump history. He hadn’t bolused since 6am!!??? What the?? Before I yelled, I realized that we ate supper at 6pm.  His pump was 12 hours off! That was a huge problem.  His highest basals were being delivered in the middle of the day rather than at night.  His insulin to carb ratios were completely off. There was no way he could possibly be in range with all of this out of whack!

I made the quick change and waited for everything to return to a more reasonable normal.  Its amazing how one little thing like am versus pm can make such a huge difference in your life! 

Time changes? Who invented them and why must they be so painful on all levels…especially when Diabetes lives with you.  

This is our “Where’s Waldo shot?”  Can you find the teen with diabetes in the trees?